Parental Substance Abuse and
Child Welfare: Promising
Programs for Early Intervention
and Permanency
Claire Houston
S.J.D. Candidate, Harvard Law School
Objectives
 Discuss entry issues related to parental substance
abuse
 Focus: referral requirement under Child Abuse
Prevention and Treatment Act (CAPTA) (2003 and
2010 amendments)
 Secondary focus: Family Drug Treatment Courts
targeting substance-exposed infants
Parental Substance Abuse
and Child Maltreatment
 Significant problem for child welfare system
 Prevalence:
 Related to 60% of abuse and neglect
 50-79% of children taken into foster care
 Poor outcomes for children:
 Enter care at a younger age
 Stay in foster care system longer
 Lower rates of reunification
 More likely to re-enter child welfare system following
reunification
 Substance-exposed infants fare worse
Substance-Abusing Parents
Have Multiple Problems
 Co-occurring problems: poverty, mental health
issues/past trauma, domestic violence, low educational
achievement
 Access to treatment issues
 Difficulties with treatment enrollment and retention
 Relapse common
Reports to Child Welfare
1. Allegation of abuse or neglect
2. Substance-exposed infants (SEI’s)
•
CAPTA: required referral for any infant, “identified as
being affected by illegal substance abuse or withdrawal
symptoms resulting from prenatal drug exposure or Fetal
Alcohol Spectrum Disorder”
Reporting SubstanceExposed Infants (CAPTA)
 Rationale: “identify infants at risk of child abuse and
neglect so appropriate services can be delivered to the
infant and mother to provide for the safety of the child”
 Tool for early intervention – prevent maltreatment
Problems with CAPTA
1. Alcohol provision limited
2. Does not establish definition of child abuse
•
•
Limits CPS involvement
At least 15 states define prenatal substance exposure as
abuse or neglect
3. “Identification” issue
Under-reporting and
Biased Reporting (CAPTA)
 Inadequacies in screening
 Risk of under-reporting
 Inconsistencies in testing (among hospitals, within
hospitals)
 Risk of biased reporting
 Risk of under-reporting of non-minority infants
 Best option: legally mandated, universal testing
Family Drug Treatment Courts
(FDTC’s)
Aims:
1. Get parent off drugs, deal with co-occurring problems
•
•
Collaboration with treatment providers
Monitor compliance
2. Promote faster permanency for children
FDTC’s as a Tool of Early
Intervention?
 Traditional FDTC
 Intervene once maltreatment has occurred
 FDTC’s geared at substance-exposed infants
 Intervene prior to maltreatment
 Work with hospitals, CPS – reporting key
 Problems with CAPTA may limit the ability of these courts
to prevent maltreatment
Questions or comments
can be directed to:
Claire Houston
chouston@sjd.law.harvard.edu